BACKGROUND: Human papillomavirus (HPV) is responsible for approximately 4.5% of all cancers globally, with the highest burden in low- and middle-income countries (LMICs). Since their introduction in 2006, HPV vaccination programs have led to substantial declines in HPV-related outcomes, although the magnitude of impact varies across settings. RESEARCH DESIGN AND METHODS: We conducted a systematic review to evaluate the population-level impact of HPV vaccination on HPV infection, cervical intraepithelial neoplasia grade 2 or higher (CIN2+), genital warts, invasive cervical cancer (ICC), and oropharyngeal cancer (OPC), and examined the influence of vaccine coverage, age at initiation, and vaccine type. We reported this review in accordance with PRISMA 2020. RESULTS: Of 13,549 records screened, 63 were included: 9 assessed impact on HPV infection, 24 on CIN2+, 25 on genital warts, and 7 on ICC. The greatest reductions were observed in settings with at least 70% vaccine coverage and early vaccination prior to sexual debut, typically achieved through school-based programs. Reported declines ranged from 58-100% for HPV infection, 30-88% for CIN2+, 60-90% for genital warts, and 70-88% for ICC. CONCLUSIONS: HPV vaccination offers strong population-level protection, especially when delivered early and at high coverage within schools. To achieve global cancer prevention goals, expanding access and prioritizing underserved populations will be essential. Limitations include heterogeneity across designs, outcome definitions, and follow-up periods.
Zeleke et al. (Wed,) studied this question.
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